摘要
目的 观察归脾培元汤联合艾灸治疗晚期癌症恶病质脾肾两虚证患者的临床疗效.方法 将 80 例晚期癌症恶病质脾肾两虚证患者按照随机数字表法分为2 组,对照组40 例在常规营养支持基础上予醋酸甲地孕酮分散片口服治疗,治疗组40 例在常规营养支持基础上予归脾培元汤联合艾灸足三里、涌泉穴治疗.2 组均治疗4 周.比较2 组治疗前后中医证候评分、细胞免疫功能(T 淋巴细胞亚群 CD3+、CD4+、CD8+及 CD4+/CD8+)、营养学指标[血红蛋白(Hgb)、白蛋白(ALB)、前白蛋白(PA)、瘦素(LP)、体质量],并统计 2 组疗效.结果 治疗组总有效率 77.50%(31/40),对照组总有效率55.00%(22/40),治疗组临床疗效优于对照组(P<0.05).2 组治疗后中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后食少纳呆、体倦乏力、腰膝酸软、神疲懒言及中医证候总分均低于对照组(P<0.05).治疗组治疗后CD3+、CD4+、CD4+/CD8+均较本组治疗前升高(P<0.05),CD8+降低(P<0.05),且治疗组治疗后CD3+、CD4+、CD4+/CD8+均高于对照组(P<0.05),CD8+低于对照组(P<0.05).治疗组治疗后Hgb、ALB、PA、LP、体质量均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05).结论 归脾培元汤联合艾灸治疗能够缓解晚期癌症恶病质脾肾两虚证患者临床症状,增加体质量,提高临床疗效,可能与调节细胞免疫功能、改善营养状况等因素有关.
Abstract
Objective To observe the clinical efficacy of Guipi Peiyuan Decoction combined with moxibustion for ad-vanced cancer cachexia(speen-kidney dificiency).Methods Eighty patients with advanced cancer cachexia(speen-kidney dificiency)were randomly assigned into treatment group(n=40)and control group(n=40).All patients were managed by conventional nutritional support,and those in control group and treatment group were additionally treated with oral megestrol ace-tate dispersible tablets and Guipi Peiyuan Decoction combined with moxibustion at Zusanli(ST36)and Yongquan(KI1),re-spectively.Treated for 4 weeks,the aim was to compare traditional Chinese medicine(TCM)syndrome scores,cellular immune function(T lymphocyte subsets CD3+,CD4+,CD8+,CD4+/CD8+),and nutritional indicators[hemoglobin[Hgb],albumin[ALB],prealbumin[PA],leptin[LP],body weight)between groups before and after treatment.The curative effect was as-sessed.Results The overall effective rate in the treatment group was better than that in the control group(77.50%[31/40]vs 55.00%[22/40],[P<0.05],respectively).After treatment,TCM symptom scores in the both groups were significantly de-creased(P<0.05),The domain scores of TCM syndromes(inappetence,physical fatigue,weak waist and knees,mental fa-tigue and lazy words)score and total score decreased notably in the treatment group compared with the control group(P<0.05).After treatment,significantly increased CD3+,CD4+,CD4+/CD8+,and decreased CD8+were found in the treatment group,and the improvements were more pronounced in the treatment group than those of the control group(P<0.05).The levels of Hgb,ALB,PA,LP,and body mass index(BMI)in the treatment group were significantly increased(P<0.05),and which were significantly higher than those in the control group(P<0.05).Conclusion For patients with advanced cancer cachexia(speen-kidney dificiency),Guipi Peiyuan Decoction combined with moxibustion can relieve clinical symptoms,it can increase BMI and improve clinical efficacy by regulating cellular immune function and improving nutritional status.
基金项目
无锡市中医药局科技项目(2021)(wxzg202108)
国家科技期刊平台
NSTL
万方数据